Individual
DR. THEODORE C PRENTICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11525 BROOKSHIRE AVE STE 205, DOWNEY, CA 90241-4982
(562) 861-1988
(562) 861-5835
Mailing address
11525 BROOKSHIRE AVE STE 205, DOWNEY, CA 90241-4982
(562) 861-1988
(562) 861-5835
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
WG38015M
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0066640
—
CA
01
—
WG38015M
LICENSE
CA
Enumeration date
08/03/2006
Last updated
04/07/2010
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